WAG 02-05-04-b: Ending PE Coverage

PM 02-05-04-b.

IES Phase 2 Process

Benefits Approved for the Child

CPE coverage will end:

  • if cash or Assist benefits are approved, the day the action is taken;
  • if All Kids Share or All Kids Premium Level 1 deleted text is approved, the day before All Kids Share or All Kids Premium  Level 1 coverage begins; or
  • if Family Health Spenddown is approved, five days after the date the approval is processed.

Example: CPE coverage was authorized beginning 02/08/16. TANF is approved on 03/04/16 with medical backdating to 02/01/16. CPE coverage will end on 03/04/16.

revised text Example: CPE coverage was authorized beginning 02/17/16. Family Health Spenddown is approved on 03/10/16 with medical backdating to 01/01/16. CPE coverage will end 03/15/16.

Benefits Denied for a Child

If the application is denied, CPE coverage will end 5 calendar days following the date of denial.

revised text Example: CPE coverage was authorized beginning 05/02/16. The application is denied on 05/27/16 due to the family's failure to provide proof of income. CPE coverage will end 06/01/16.

Legacy Process

Benefits Approved for the Child

PE coverage will end:

  • if cash or Assist benefits are approved, the day the action is taken;
  • if All Kids Share or All Kids Premium is approved, the day before All Kids Share or All Kids Premium coverage begins; or
  • if Family Health Spenddown is approved, five days after the date the approval is processed.

Example: PE coverage was authorized beginning 05/14/04. TANF is approved on 06/25/04 with medical backdating to 05/01/04. PE coverage will end on 06/25/04.

Example: PE coverage was authorized beginning 05/31/04. All Kids Share is approved on 07/01/04 with coverage beginning 08/01/04. PE coverage will end on 07/31/04.

Example: PE coverage was authorized beginning 05/14/04. Family Health Spenddown is approved on 07/01/04 with medical backdating to 03/01/04. PE coverage will end 07/06/04.

Benefits Denied for a Child

If the application is denied, PE coverage will end 5 calendar days following the date of denial.

Example: PE coverage was authorized beginning 05/14/04. The application is denied on 06/15/04 due to the family's failure to provide proof of income. PE coverage will end 06/20/04.